Taynãna César Simões

Bromeliad-inhabiting mosquitoes in an urban botanical garden of dengue endemic Rio de Janeiro - Are bromeliads productive habitats for the invasive vectors Aedes aegypti and Aedes albopictus?

Immatures of both Aedes aegypti and Aedes albopictus have been found in water-holding bromeliad axils in Brazil. Removal of these plants or their treatment with insecticides in public and private gardens have been undertaken during dengue outbreaks in Brazil despite uncertainty as to their importance as productive habitats for dengue vectors. From March 2005-February 2006, we sampled 120 randomly selected bromeliads belonging to 10 species in a public garden less than 200 m from houses in a dengue-endemic neighborhood in Rio de Janeiro. A total of 2,816 mosquito larvae and pupae was collected, with an average of 5.87 immatures per plant per collection. Culex (Microculex) pleuristriatus and Culex spp of the Ocellatus Group were the most abundant culicid species, found in all species of bromeliads; next in relative abundance were species of the genus Wyeomyia. Only two individuals of Ae. aegypti (0.07%) and five of Ae. albopictus(0.18%) were collected from bromeliads. By contrast, immatures of Ae. aegypti were found in manmade containers in nearly 5% of nearby houses. These results demonstrate that bromeliads are not important producers of Ae. aegypti and Ae. albopictus and, hence, should not be a focus for dengue control. However, the results of this study of only one year in a single area may not represent outcomes in other urban localities where bromeliads, Ae. aegypti and dengue coincide in more disturbed habitats.

Modeling the Non-Stationary Climate Dependent Temporal Dynamics of Aedes aegypti

Background Temperature and humidity strongly affect the physiology, longevity, fecundity and dispersal behavior of Aedes aegypti, vector of dengue fever. Contrastingly, the statistical associations measured between time series of mosquito abundance and meteorological variables are often weak and contradictory. Here, we investigated the significance of these relationships at different time scales. Methods and Findings A time series of the adult mosquito abundance from a medium-sized city in Brazil, lasting 109 weeks was analyzed. Meteorological variables included temperature, precipitation, wind velocity and humidity. As analytical tools, generalized linear models (GLM) with time lags and interaction terms were used to identify average effects while the wavelet analysis was complementarily used to identify transient associations. The fitted GLM showed that mosquito abundance is significantly affected by the interaction between lagged temperature and humidity, and also by the mosquito abundance a week earlier. Extreme meteorological variables were the best predictors, and the mosquito population tended to increase at values above and 54% humidity. The wavelet analysis identified non-stationary local effects of these meteorological variables on abundance throughout the study period, with peaks in the spring-summer period. The wavelet detected weak but significant effects for precipitation and wind velocity. Conclusion Our results support the presence of transient relationships between meteorological variables and mosquito abundance. Such transient association may be explained by the ability of Ae. aegypti to buffer part of its response to climate, for example, by choosing sites with proper microclimate. We also observed enough coupling between the abundance and meteorological variables to develop a model with good predictive power. Extreme values of meteorological variables with time lags, interaction terms and previous mosquito abundance are strong predictors and should be considered when understanding the climate effect on mosquito abundance and population growth.

Diet-Induced Nutritional Stress and Pathogen Interference in Wolbachia-Infected Aedes aegypti

The pathogen interference phenotype greatly restricts infection with dengue virus (DENV) and other pathogens in Wolbachia-infected Aedes aegypti, and is a vital component of Wolbachia-based mosquito control. Critically, the phenotype’s causal mechanism is complex and poorly understood, with recent evidence suggesting that the cause may be species specific. To better understand this important phenotype, we investigated the role of diet-induced nutritional stress on interference against DENV and the avian malarial parasite Plasmodium gallinaceum in Wolbachia-infected Ae. aegypti, and on physiological processes linked to the phenotype. Wolbachia-infected mosquitoes were fed one of four different concentrations of sucrose, and then challenged with either P. gallinaceum or DENV. Interference against P. gallinaceum was significantly weakened by the change in diet however there was no effect on DENV interference. Immune gene expression and H2O2 levels have previously been linked to pathogen interference. These traits were assayed for mosquitoes on each diet using RT-qPCR and the Amplex Red Hydrogen Peroxide/Peroxidase Assay Kit, and it was observed that the change in diet did not significantly affect immune expression, but low carbohydrate levels led to a loss of ROS induction in Wolbachia-infected mosquitoes. Our data suggest that host nutrition may not influence DENV interference for Wolbachia-infected mosquitoes, but Plasmodium interference may be linked to both nutrition and oxidative stress. This pathogen-specific response to nutritional change highlights the complex nature of interactions between Wolbachia and pathogens in mosquitoes.

Impact of vaccination on the incidence of measles in Mozambique in the period 2000 to 2011

This study aimed to evaluate associations among variables in hospital pharmacy services. Thirty variables were used from the project Diagnosis of Hospital Pharmacies in Brazil pertaining to the overall description of the hospital, overall characterization of the hospital pharmacy service, and stages in pharmaceutical care. The statistical techniques were multiple correspondence and cluster analysis. Dimension 1 of the multiple correspondence analysis explained 90.6% of variance, differentiating between hospital pharmacy services based on the presence of certain activities, thus suggesting an axis of characterization for the hospital pharmacy services. The results indicate a direct relationship between compliance with the activities and the type of hospital and pharmacists with specialized training. Cluster analysis identified six clusters related to hospital size; greater compliance with the activities was associated with large hospitals and those with a pharmacist (more time dedicated to the hospital pharmacy service and higher level of training). The study concludes that the techniques were able to identify associations and a concise range of variables for a comprehensive evaluation of hospital pharmacy services in Brazil.

Predictors for papillary thyroid cancer persistence and recurrence: a retrospective analysis with a 10-year follow-up cohort study

We aimed to determine outcome predictors of papillary thyroid cancer (PTC) persistence and recurrence, separately.

Impacto da vacinação sobre a incidência de sarampo em Moçambique no período de 2000-2011

The aim of this study was to contribute to the better planning of measles elimination actions in Mozambique, by considering the impact of vaccination actions over the period 2000 to 2011. Descriptive and ecological studies and case records made available by the Ministry of Health were used to analyze measles vaccination coverage. Statistical analysis was performed using time series and spatial analysis. Vaccine coverage rates ranged from 82% to 99%. Coverage rates in Maputo city were under 70% and in Niassa province they were over 100%. Coverage showed a clustered pattern in the districts. The measles incidence rate was 1.58 per 100,000 inhabitants (0.00-40.08 per 100,000 inhabitants); districts bordering neighboring countries presented high incidence rates. Although measles morbidity and mortality has decreased in Mozambique, vaccine coverage has been insufficient to interrupt measles transmission. Enhanced surveillance, including investigation of cases and outbreaks, and improvements in measles vaccination are recommended in order to achieve a homogenous coverage rate of ≥ 95% for both routine and mass vaccination campaigns.O objetivo deste estudo foi analisar as acoes de eliminacao do sarampo em Mocambique, considerando o impacto do programa de vacinacao ao longo do periodo de 2000-2011. Foram revisados os dados de vacinacao e os casos de sarampo disponiveis no Ministerio da Saude. Analise de series temporais e tecnicas estatisticas de analise espacial foram aplicadas. As coberturas variaram entre 82% e 99%. Nas provincias, a cidade de Maputo teve as coberturas abaixo de 70%, e a provincia de Niassa teve as coberturas acima de 100%. As coberturas apresentaram um padrao espacial que se modificou com o tempo. A taxa de incidencia de sarampo no pais foi de 1,58 (0,00-40,08 distritos) por 100 mil habitantes. Os distritos que fazem fronteiras com os paises vizinhos tiveram as elevadas taxas de incidencia. As coberturas de rotina sao insuficientes, e a circulacao de sarampo continua em Mocambique. O pais necessita alcancar coberturas homogeneas e maiores que 95% em criancas menores de um ano, manter as campanhas de vacinacao e melhorar a vigilância e o tratamento de casos.

Aspects of the ecology of phlebotomine sand flies (Diptera: Psychodidae) in the Private Natural Heritage Reserve Sanctuary Caraça

Leishmaniases are a set of parasitic diseases of zoonotic origin that are transmitted by sandfly vectors in wild, rural and urban environments. Their distribution is dependent not only the distribution of vectors, but also on the distribution of mammalian reservoirs. Only by understanding the transmission cycle of these diseases, such as knowing the participating vectors and reservoirs, can one can understand the epidemiology and ecological relationships of leishmaniases. Ecotourism has become an important area of economic growth in Brazil. One of the most visited tourist attractions in the state of Minas Gerais, the Reserva Particular do Patrimônio Natural Santuário do Caraça (RPPNSC) is located in the Quadrilátero Ferrífero. The aim of this study was to contribute to the control of leishmaniasis among tourists of the RPPNPC by surveying its sand fly fauna and testing for the presence of Leishmania DNA in females. Twenty-five CDC light traps were exposed on 7 trails of the RPPNPC where samples were collected bimonthly for a year, starting in June 2013. A total of 376 specimens of 18 species and 10 genera of sandflies were captured. The predominant species were Psychodopygus lloydi (72.34%) and Pintomyia monticola (5.59%). HaeIII restriction enzyme detected and characterized Leishmania braziliensis DNA in 2 of the samples for an infection rate of 0.7% (2/266). Recent studies found specimens of Ps. lloyd infected with Leishmania braziliensis elsewhere in Minas Gerais, which may be an indication that this species is involved in the transmission of Leishmania in this state.

Estado nutricional e fatores associados em idosos: evidências com base em inquérito telefônico

Objective: To evaluate the nutritional status and associated factors in the elderly. Methods: This is a cross-sectional study, carried out between June and October 2016, with 720 elderly individuals. It used demographic, socioeconomic, behavioral and health status information on individuals aged 60 years or older, originating from the system Surveillance of Risk and Protective Factors for Chronic Diseases through Telephone Survey (VIGITEL), in the year 2013. The measures of association for overweight and obesity were adjusted according to some variables studied, on the binomial logistic model. Results: Most of the participants were women (59.7%, n=430), with education until middle school (70.5%, n=508), and did not work (75.2%, n=541). The prevalence of excess weight and obesity in the elderly was 57.5% (n=414) and 19.9% ​​ (n=143), respectively. Main meals were replaced with snacks (five or more times per week) by 33.8% (n=243) of the elderly. High blood pressure was reported by 62.8% (n=452) of the elderly; 21.2% (n=153) were diabetic, 35.4% (n=255) had high cholesterol, and 35.4% (n=255) had dyslipidemia. Being hypertensive and having dyslipidemia increased the likelihood of being overweight. Increasing age reduced the likelihood of being overweight. Obesity was positively associated with hypertension, dyslipidemia and female gender. Conclusion: A high percentage of excess weight and obesity was observed, and elderly individuals with high blood pressure, dyslipidemia and the habit of replacing main meals with snacks were more likely to be overweight and obese.

Acesso da população brasileira adulta a medicamentos prescritos

OBJECTIVE To estimate the prevalence and check the factors associated with access to prescribed medicine by the Brazilian adult population; and to describe the distribution of the presence of monetary expenditure for the purchase, source of medicines, and the reasons for non-access. METHODS Based on a cross-sectional design, from the 2013 National Health Research data, we analyzed a representative sample of the population that comprised adults with prescriptions written by a health professional, in the two weeks prior to the survey. The dependent variable was the access to prescribed medicines (full access, partial access, no access). Data were analyzed using the multinomial logistic regression considering total access as the reference category. RESULTS The results showed high prevalence of full access to prescribed medicine in Brazil (83.0%; 95%CI 81.3 - 84.6). Most of the individuals had monetary expenditure on the purchase of medicines (63.9%), and the main reasons for no access were the lack of medicine in the public health service (57.6%) and having no money (11.9%). We found higher chances of partial access among individuals attending the public service (OR = 2.5; 95%CI 1.58 - 3.97). Greater chance of no access was associated with non-white skin color (OR = 1.43; 95%CI 1.03 - 1.99). CONCLUSION The results revealed significant inequity in access to medicine, emphasizing the need to strengthen the Unified Health System for the free supply of medicines in order to reduce inequalities.

Inequalities in esophageal cancer mortality in Brazil: Temporal trends and projections.

The main objective of the study was to analyze the effect of age, period and birth cohort on esophageal cancer mortality in Brazil and its geographic regions, per sex. An ecological study is presented herein, which evaluated the deaths by esophageal cancer and the distribution, per geographic region. Poisson Regression was utilized to calculate the effects of age, period and birth cohort, and projections were made with the statistical software R, using the age-period-cohort model. Projection of data covered the period 2015–2029. Regarding the geographic regions of Brazil, a decrease was verified, throughout time, for the mortality rates of the South and Southeast regions, for men and women. For the North, Northeast and Midwest regions, an increase was evidenced in mortality rates, mainly for men, after the 2000s. Regarding the projections, a progressive increase of mortality rates was verified for the Northeast and North regions. Divergences evidenced for observed and projected esophageal cancer mortality rates revealed inequalities among the geographic regions of Brazil.